Abstract
ObjectiveCerebral white matter hyperintensity (WMH) is prevalent in the elderly population and is associated with hypoperfusion and ischemia presumably due to altered cerebral autoregulation (CA). Our study sought to examine the association between cerebral white matter structural integrity and dynamic CA in elderly individuals.MethodsFifty‐three subjects (75±7 years, Mean ± SD) were enrolled in the study and WMH was assessed using magnetic resonance imaging and microstructural integrity of the white matter (WM) was estimated from fractional anisotropy (FA) and mean diffusivity (MD) using diffusion tensor imaging. Arterial blood pressure and middle cerebral artery blood velocity (MCAV) was obtained using finger plethysmography and Transcranial Doppler ultrasound while subjects were seated upright for 5 minutes. Transfer function analysis was used to evaluate dynamic CA.ResultsHigher phase (better CA) in the low‐frequency range (0.03–0.15Hz) was associated with smaller WMH volume (P = 0.02), higher FA (better microstructural integrity) in normal WM (P <0.001) and WMH (P= 0.001) and lower MD (better microstructural integrity) in normal WM (P= 0.006) and WMH (P= 0.012).ConclusionOur results suggest that higher WMH burden and loss of cerebral microstructure integrity are associated with impaired dynamic CA in elderly individuals.Research supported by NIH T32 grant (5 T32 AG 23480–7).
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